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Individual

DR. MITCHELL S GARDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
538 LITCHFIELD ST STE 202, TORRINGTON, CT 06790-6669
(860) 361-6650
(860) 361-6654
Mailing address
538 LITCHFIELD ST STE 202, TORRINGTON, CT 06790-6669
(860) 361-6650
(860) 361-6654

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
044118
CT
207X00000X
Orthopaedic Surgery Physician
Primary
044118
CT
207XS0117X
Orthopaedic Surgery of the Spine Physician
044118
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000038402
GHI HMO #
NY
05
01694311
NY
01
0599833
GHI PPO #
NY
01
141796305
TAX IDENTIFICATION #
NY
01
2071599
AETNA HMO #
NY
01
5724688
AETNA PPO #
NY
01
691155
MVP PROVIDER #
NY
01
P958616
OXFORD PROVIDER #
NY
Enumeration date
05/31/2005
Last updated
08/30/2024
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